The BBC’s Jenny Hill in Berlin says the case is sensitive for German health authorities which are accused by relatives of turning a blind eye to Högel murderous activity.
Investigators say he may have killed even more but potential victims have been cremated.
“I hope he will be found guilty on each count so that the loved ones can finally find some closure,” said Petra Klein, who runs a victims’ support group.
Relatives of his alleged victims packed the court.
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